total ankle replacement at 45 years old dot do or not to do that is the question

I did it! June 6th,2018

17 years ago, I broke my ankle sliding into second base, I was safe in case you were wondering, July 2001. I ended up with 10 screws and a plate once they straightened my toes back to where they belonged. 

After healing, over the years nothing really slowed me down. Which in turn caused me to suffer ongoing pain in my ankle. After a while the cortisone shots did not help anymore. I decided to look into total ankle replacements. I was at end stage advanced osteoarthritis.

I had 4 opinions one Dr. in Indiana, one in Rochester, and two in Buffalo, NY. They were all on the same page that I was a good candidate after reviewing my MRI and x-rays however,  my age was the only thing keeping me from being the “perfect” candidate. Actually make that 5 Dr.’s. The fifth Dr. didn’t agree and only offered the option of ankle fusion. The fusion statistics show more people are coming back now after having done fusion 15 years before with arthritis in other areas of the ankle so now they are in pain again.

In regards to my age and having this done the reason they thought I was to young was because they normally only like to do replacements one time on a patient. It will be more then that for me but I didn’t  want to wait, mainly because I was having chronic pain. Second I’d rather be able to more more active while I’m younger and then if I need another at 60-65 I’ll still be able to have another replacement or a revision because that’s still young.

I wasn’t sure about which Dr and which implant to use, there are many different manufacturers. I decided on the Zimmer because 2 of the 4 Dr.s used it and it was placed through the side of your ankle instead of through the front which I liked so they could use my previous scar.. It also took the least amount of bone away during preparation.

Between myself and my fiancé many hours of research took place. The Zimmer TAR only has about 5 years of data behind it but other in-house testing has been done. So my types of replacements and I believe they are into the third generation of replacements.

So for almost a year I wore an AFO brace that really did help. I could only wear sneakers with it but it limited my range of motion which limited my pain. But after almost a year of wearing that I  was ready for my next step because I was still in constant pain everyday. Dull mostly but constant. Very few days went by that I did end my day with my ankle elevated with an ice pack.

I decided to go with my regular orthopedic surgeon since he learned from the Dr. in Indiana that helped create the design of the Zimmer implant. So after being on an RV trip for a few months I came home an made a Dr. appointment immediately.i went to my appointment and told him I want it done ASAP. 4 weeks later I’m being wheeled into surgery prep.

I was ready.  I was in discomfort everyday and anxious to be out of pain. I heard the statistic about the Zimmer implant…. 90% of patients that had TAR had 90% less pain. That’s what I’m looking forward to ultimately. Also, can’t wait to wear sandals and other shoes besides sneakers😊

In the days leading to up to June 6th,  2018 I was nervous on the inside. My body was reacting in strange ways. All the ways a nervous body would react but I didn’t feel overly nervous just more excited. My family was starting to decided who would do what chores. My 21 year old son picked some and the days he would do them…he likes to be organized. My step daughter volunteered for grocery shopping and some cleaning. I guess most else will fall into my fiancé’s shoulders. I’ll tell you though it’s important to have your family behind you. I’m so blessed to say I have so much support. My family is freakin awesome!

I’m totally prepared for when I get back home. I have my shower seat, my crutches and a knee scooter.

My mom came up the night before and went to the hospital to wait for me. My fiancé dropped us off and would be coming back later with the rest of my family. My mom is always there for me I can always count on her and she can always count on me.

The surgery was about 2 hours and about an hour in recovery then I was in my room and my family came in. I was so excited to see them. I was very sleepy going in and out. About 10pm or so the nerve block was wearing off the pain was kicking in. I was given pain meds and nausea meds. My room was terribly hot but I had a roommate that was a little older so I didn’t want her to be cold.

The nurses and assistants were very helpful. Because I normally take medicine for overactive bladder ( which I couldn’t take that day) along with sipping water and the IV I was having to use the restroom every hour or hour and a half. It was difficult every time to get up and I also had to turn the light on and I felt like I kept waking my roommate. I felt terrible but if you gotta go you gotta go. The nurse removed my IV around 3 am and that helped a lot.also discussed that the walker was working real good for me and helping be feel more stable then crutches. So I went home with a walker.

                                                                     Still in the hospital here

Needless to say I got about 2 hours of sleep and boy was I tired. I was able to be discharged early my fiancé came around 10 and we left around 11am. I was very excited to go home and that he brought me a Tim Hortons coffee!

I took a 3 hour nap which was amazing. My family has been wonderful. The rest of day 2 I slept off and on and the pain was moderate. It was completely manageable if I stayed on top of my pain meds. 2 tabs of hydrocodone every 6 hours. 

Day 3 after surgery, Friday, was also pretty good. Still in pain but not unbearable. I am still taking 2 pain pills every 6 hours. I have experienced a lot of throbbing when I put my leg down to go to the bathroom. It’s so Important at this point to keep my leg elevated, so I’ve been a good girl following the rules.

Day 4, Saturday,I was up at 2am to take pain meds so I didn’t get behind and have the pain creep up on me. Unfortunately it wasn’t that easy to go back to sleep. But I wasn’t in a lot of pain so it was ok.

In the midst of all this I have been in a lot of pain in my left hand thumb joint area and down into the wrist and pointer and ring finger joints. Arthritis I think but it hurts pretty bad so not sure. The pain pills must only be focusing on my ankle because it hasn’t helped my hand at all. 

Had a nice breakfast in bed eggs, home fries and toast compliments of my wonderful fiancé?? My son has come into to my room to take any garbage away and pick up so my room looks neat. 

Pretty much don’t remember what exactly happened the rest of the weekend, thanks to the pain meds.

Well one thing I do remember is developing a rash and severe itching with the hydrocodone. So I decided to just try Tylenol. Didn’t really cut it. I am now taking tramadol which has been helping. 

Day 6 , Tuesday. I was very excited because my first Dr. appointment was today. Last night I kinda of freaked out with the splint and all that wrap. Kinda of like people get when having a cast on. I got very anxious and had antsy legs very bad. I tried some milk for that but didn’t help. Ended up taking 2 mg of Lorazapam so I could relax. 

Yahoo! Splint is off. Dr. P said everything looked great! He changed the dressing on all the areas and then wrapped in an ace bandage., The  boot on top of that. I like the boot. It’s kinda heavy but I’m happy I get to take it off whenever I want. He said I could take the boot and bandages off and let the incision get fresh air a few times a day. Next appointment June 21, 2018 it to have the 30 staples taken out…yikes sounds painful I better save some pain medicine for that day.

Here’s an X-ray and incision without bandage: oh and my kitty,s being loyal sh

Just a tip about pain medication. Since you can take every 6 hours and to keep pain manageable I recommend 6am and 12pm the 6pm and 12am. Im at 7 days right now and I’m still taking it but hoping to decrease at least to 1 pill soon. 

Oh, today’s my Birthday ??. I’m know my fiancé is making me a special dinner tonight and my mom is coming too. It’s gonna be a wonderful day!

Turned out to be exactly that, a wonderful day. I was downstairs for the 2nd time in 7 days and it felt good. 

8 days after surgery. The swelling is finally starting to decrease. I have been elavating it above my heart and icing it like crazy 30 mins on 10 off. Following this regimen definitely makes a difference. I even have about 5 degree movement with minimal pain. My pain right now is basically from my incision. I’m sure different pain will come once I can start moving it. The throbbing has decreased when I put it down. It’s nice that I can take the boot off and the dressing and allow the leg to get nice room temp air.

A few times I have lost it. Feeling hopeless, agitated and frustrated. I cry like a baby but it’s ok. My fiancé talks me down, he’s amazing. This is when I turn to other people’s blogs to give me hope and encouragement because most have a very happy painfree ending to their stories. I am confident my ending will be that way it just doesn’t seem it now.

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